Todd M. Bull, MD, FACP
Associate Professor of Medicine
Division of Pulmonary Sciences and Critical Care Medicine
University of Colorado Health Sciences Center
Vallerie V. McLaughlin, MD
Professor, Internal Medicine
The University of Michigan
Ann Arbor, MI
Richard N. Channick, MD
Director, Pulmonary Hypertension Program
Massachusetts General Hospital
AMA PRA Category 1 Credit™ Medium
A video roundtable discussion of key information presented at the American Thoracic Society annual meeting in New Orleans, May 14-19, 2010, including discussion of longer-term outcomes data from patient registries, methods to assess patient risk, and clinical trial data on existing and emerging therapies and their implications for patient management.
NOTE: THIS PROGRAM IS NOT AFFILIATED WITH AND HAS NOT RECEIVED AN ENDORSEMENT BY THE AMERICAN THORACIC SOCIETY.
Pulmonary arterial hypertension (PAH) comprises a group of diseases characterized by vascular proliferation and a progressive increase in pulmonary vascular resistance that ultimately leads to right ventricular failure and early mortality. Three classes of drugs acting on different pathways related to vasodilation and vascular remodeling, have been approved for the treatment of PAH in the last 15 years. In spite of this remarkable increase in available treatment options for PAH, the overall mortality rate associated with PAH did not change significantly between 1980 and 2002.
A recent analysis has shown that a number of barriers exist that prevent optimal care of patients who may be at risk for or may already be experiencing PAH. Clinicians have difficulty in choosing from among pharmacological therapies for PAH. Many physicians are not familiar with the latest advances in PAH diagnosis and monitoring strategies, including methods to assess patient risk. In addition, physicians are not always tailoring treatment based on different PAH classifications and may not treat aggressively enough based on available data on therapeutic options.
The factors that limit clinicians’ ability to provide PAH patients with the best possible care are complex. Continuing clinician education is crucial to improving the management of the potentially fatal effects of PAH. Program Developer/Facilitator
Jointly Provided by the University of California, Irvine School of Medicine and
MCM Education Target Audience
Pulmonologists, cardiologists, and critical care specialists
Upon completion of this educational activity, the participant should be able to:
Evaluate the levels of evidence surrounding the different types of drugs that are currently used to treat PAH.
Assess and implement some recent advances in the evaluation and treatment of patients with PAH.
Outline how clinicians should tailor PAH treatments based on patient factors and comorbidities.
It is the policy of the University of California, Irvine School of Medicine and the University of California CME Consortium to ensure balance, independence, objectivity and scientific rigor in all CME activities. Full disclosure of conflict resolution can be found below.
Dr. Bull discloses that he is a consultant for Actelion and Lung Rx, which could be perceived as a potential conflict of interest in this presentation. Dr. Bull has disclosed that based on his potential conflict of interest his presentation has been peer reviewed for evidence base and fair balance.
Dr. McLaughlin discloses that she is a consultant for Actelion, Gilead, and Mondo Biotech (Bayer); a member of the speakers bureau for Actelion and Gilead; and has received grant support from Actelion, Gilead, United Therapeutics, Novartis, and Mondo Biotech (Bayer), which could be perceived as a potential conflict of interest in this presentation. Dr. McLaughlin has disclosed that based on her potential conflict of interest her presentation has been peer reviewed for evidence base and fair balance.
Dr. Channick discloses that he is a consultant for and has received grant/research funding from Actelion, United Therapeutics, and Gilead and is a member of the speaker's bureau for Actelion, which could be perceived as a potential conflict of interest in this presentation. Dr. Channick has disclosed that based on his potential conflict of interest his presentation has been peer reviewed for evidence base and fair balance.
In accordance with the ACCME Essential Areas and policies regarding commercial support, the audience is advised that the following faculty will discuss unlabeled or unapproved uses of drugs or devices.
Dr. Bull's, Dr. McLaughlin's, and Dr. Channick's presentations will include discussion of off-label, experimental, and/or investigational uses of bosentan, imatinib, riociguat, selexipag, and sildenafil in the management and treatment of patients with pulmonary arterial hypertension.
Conflict Resolution: Samuel Wilson, M.D., has peer reviewed this activity for evidence base and fair balance. Dr. Wilson disclosed that he has no relevant relationship with any drug or device company that would create a potential conflict of interest.
The Planning Staff of the University of California, Irvine School of Medicine and Medical Communications Media have nothing to disclose. The Peer Reviewer has disclosed he has no relationships with any drug or device company. The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the University of California, Irvine School of Medicine or Medical Communications Media. Credit Statements
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of California, Irvine School of Medicine and Medical Communications Media. The University of California, Irvine School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation Statement
The University of California, Irvine School of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
California Assembly Bill 1195
This activity is in compliance with California Assembly Bill 1195, which requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. For specific information regarding Bill 1195 and definitions of cultural and linguistic competency, please visit the CME website: http://www.meded.uci.edu/CME/CME-H-AB1195.htm. Commercial Support Statements
Supported through educational grants from Actelion Pharmaceuticals and United Therapeutics.